Ear of Grain is an unlockable trinket in Joseph, a mod for The Binding of Isaac.

After entering a Boss Room, Famine will fly in from off-screen as an additional boss to fight. Isaac must defeat both bosses in order to proceed.

Famine's health scales per floor.

Upon dying, Famine will drop either a Cube of Meat or a Ball of Bandages, even before the fight is over.

Famine will only spawn once per floor.

Defeat Mother as Joseph.

• Download Joseph from the Steam Workshop.